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BMC Pediatrics
Published in: BMC Pediatrics 1/2017

Open Access 01-12-2017 | Research article

Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study

Authors: Silvia Iacobelli, Evelyne Combier, Adrien Roussot, Jonathan Cottenet, Jean-Bernard Gouyon, Catherine Quantin

Published in: BMC Pediatrics | Issue 1/2017

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Abstract

Background

Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA).

Methods

This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32–43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 – 28), post-neonatal hospitalization (day of life 29 – 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used.

Results

The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 – 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3–3.9] at 32 and 1.5 [95% CI: 1.1–1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4–5.8] at 32 and 6.6 [95% CI: 2.1–20.9] at 43, compared to 40 weeks.

Conclusion

There’s a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality.
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Metadata
Title
Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study
Authors
Silvia Iacobelli
Evelyne Combier
Adrien Roussot
Jonathan Cottenet
Jean-Bernard Gouyon
Catherine Quantin
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2017
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-017-0787-y

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